Shot, shattered and bloody at Ramallah's hospital

Some of the paramedics have also been hit, and several require treatment for tear gas inhalation [EPA]

Ramallah, occupied West Bank - Twenty-nine-year-old Ameen al-Teel is a head nurse at the Ramallah Government Hospital. He has been working 17-hour shifts, interspersed with just a few fitful hours of sleep, since the clashes have intensified between Israeli forces and Palestinians in the occupied West Bank and East Jerusalem.

Now, among the trees and plants of the hospital garden, al-Teel, the father of two from Hebron, in the southern West Bank, is taking a 20-minute break to eat a late breakfast.

"We normally work five eight-hour shifts a week, but with the current violence, we are working extended hours - and even those staff who are off are coming in to help out," he explains.

He is tired but calm. In fact, al-Teel almost always remains composed; he must if he is to focus on treating his patients. But there was a moment last week when he couldn't hold back his tears.

Thirteen-year-old Ahmed Sharaka from the Jalazone refugee camp near Ramallah was shot in the chest and abdomen by Israeli soldiers. He had bled to death.

The Israeli soldiers delayed an ambulance and he started bleeding extensively at the scene and on the way to hospital. According to the medical staff, bullets from a 0.22-calibre Ruger and an M16 were lodged inside his body.

"I broke down when I saw a packet of chips in his pocket," al-Teel says. Some of the hospital staff were angry; al-Teel just cried.

"There have been more than 300 wounded brought in during the last couple of weeks. Eighty of these were serious cases, including 15 children who were shot with live ammunition," he says, looking away as he remembers some of the more distressing injuries.

'With the current violence, we are working extended hours,' says Ameen al-Teel [Mel Frykberg/ Al Jazeera]

The doctors, nurses and paramedics at the Ramallah hospital - there are anywhere between six to eight nurses and three to four doctors on duty on a normal shift - are on standby, preparing for the next wave of Palestinian casualties to arrive.

Besides shattered bones, there are also high numbers of severe chest and abdomen injuries. There are currently four cases in A&E, one of whom will not survive.

Muhammad Sweity, surgeon

To deal with the influx, many are working beyond their normal hours, desperately trying to save lives while ignoring the effect of the long hours on their own mental and physical well-being.

"Some of my staff may be suffering from post-traumatic stress disorder [PTSD]," explains 27-year-old doctor Ali Amou, who is working today as the head physician in the accidents and emergency department (A&E), where many of the patients end up.

The smell of sweat, old blood and disinfectant lingers here, and Amou works as he talks. With 15 beds, 22 nurses and 16 doctors, the A&E functions a bit like a beehive - everybody knows their role and everybody has a job to do.

"However, in our society, this condition is not really recognised, and we have no counselling programmes for our staff to help them cope with the enormous stress and workload they are currently under," he adds.

Nurse Kamal Hashash, 27, at the A&E is from the Balata refugee camp. It is regarded as one of the most dangerous areas in the West Bank and was the site of regular raids by Israeli soldiers during the second Intifada.

Around 365 Palestinians are thought to have been killed there at that time, with many others wounded and arrested. Hashash admits that he becomes angry when he sees the injuries of some of the patients.

"When I saw the injuries to 17-year-old Laith al-Khaldi, who was shot in the back for throwing stones, it did upset me," he says. "He had been shot with a special kind of bullet which does maximum damage to internal organs. His entrails were hanging out of a huge exit hole in his abdomen," Hashash continues.

Al-Khaldi was brought in on August 1. The staff, which included his mother - a nurse at the hospital, worked hard to stop his bleeding. He was operated on between four and six hours and then transferred to the A&E. Fifteen minutes later, he died.

But here, even anger must be measured. Al-Teel says doctors and nurses often walk away to compose

The smell of sweat, old blood and disinfectant lingers here [Mel Frykberg/Al Jazeera]

themselves, spending a few moments alone in the bathroom. Still, it is sometimes etched onto their faces.

Orthopaedic surgeon Muhammad Sweity, 28, from Hebron, says a number of the casualties have fractured bones as a result of the bullets.

"I've just finished a two-hour operation trying to repair a fractured femur," he explains.

"Besides shattered bones, there are also high numbers of severe chest and abdomen injuries. There are currently four cases in the A&E, one of whom will not survive," Sweity continues.

Some of the bullets used by the Israeli soldiers fragment inside the body, causing severe damage to internal organs, the doctors said. Some of the bullets used are called dum-dum bullets, which expand inside the body upon impact, but doctors are not sure what other types of bullets are being used by the Israeli army.

Meanwhile, news arrives of a student march from Birzeit University to Balou on the outskirts of Ramallah. The staff begin preparing for the next influx of injured Palestinians - assembling bandages and other medical equipment and readying the ICU.

The students have been protesting almost daily since the uprising began at the beginning of the month.

Soon, half-a-dozen ambulances arrive, their lights flashing and sirens screaming as they make their way through the flying rocks and tear gas.

Several ambulances turn back before dropping off their wounded passengers - there are others who need to be brought in, and they will eventually bring in two or three patients at a time.

When the ambulances arrive, the paramedics jump out, unloading their patients onto stretchers and shouting details of the injuries to the waiting A&E nurses and doctors.

The protesters have been battling the Israeli soldiers with rocks and, occasionally, Molotov cocktails. The Israelis have been using rubber-coated steel bullets, live ammunition and tear gas.

Some of the paramedics have also been hit, and several require treatment for tear gas inhalation and cuts caused by the shattered glass of their windshields after Israeli soldiers fired rubber bullets at them.

One of the newly arrived patients has been shot in the leg with an M16 bullet. He's clearly in pain but doing his best not to show it. Steel pins will later be inserted in order to reset the shattered bones and help them grow together again.

"Nevermind," says Ahmed Habash*. "Even though I'm in a lot of pain, I can still walk."

"This is our life," adds the 24-year-old, whose brother is serving four life sentences in an Israeli prison for killing four Israeli settlers during the second Intifada.

Over the next few hours, more young men with bullet wounds in their legs are rushed in. Some wear masks to protect their identities.

"It's chaos," explains 24-year-old nurse Isra' Marna. "The cleaners have to continually clean the bloody floors of bandages and other used medical equipment."

Several conversations are being shouted simultaneously as commands are given, questions are asked and warnings are issued - all the while, the staff keep on working.

But for al-Teel, it is time to go home. He will have a few days off now and is looking forward to spending time playing with his young daughters. It helps to relieve the stress, he says.

As he waits for the driver who will take him back home to Hebron, he remembers an incident a short while ago when he treated four settlers who had been seriously injured in a car accident in the West Bank, accompanying them in an ambulance to an Israeli hospital in Jerusalem.